Budd Keith
Pain Management, Newlands, Chevin Avenue, Menston LS29 6PE, UK.
Biomed Pharmacother. 2006 Aug;60(7):310-7. doi: 10.1016/j.biopha.2006.06.015. Epub 2006 Jun 30.
For more than 100 years, the use of opioid analgesic agents has been linked with modulation of the immune system in man. More recently, it has become apparent that both exogenous and endogenous opioids exert some effect upon the immune system but that this can be beneficial or deleterious depending on numerous variables. Of the strong opioid analgesics in current use, the majority are seen to cause immunosuppression in man. However, it still remains unclear whether this is clinically important in man although it would appear to be good practice to avoid such agents in patients already immunosuppressed by disease or pharmacotherapy. Powerful opioid analgesics without immunosuppressive properties can be selected and should be used in such situations and as these agents can offer additional benefits in addition to their non-immunosuppresive analgesia, it should be considered whether to use them at all times in preference to immunosuppressive opioids.
100多年来，阿片类镇痛剂的使用一直与人体免疫系统的调节有关。最近，越来越明显的是，外源性和内源性阿片类物质都会对免疫系统产生一定影响，但这可能有益也可能有害，具体取决于众多变量。在目前使用的强效阿片类镇痛药中，大多数被认为会导致人体免疫抑制。然而，目前仍不清楚这在临床上对人体是否重要，尽管对于已经因疾病或药物治疗而免疫抑制的患者，避免使用此类药物似乎是一种明智的做法。可以选择并应在这种情况下使用无免疫抑制特性的强效阿片类镇痛药，由于这些药物除了具有非免疫抑制性镇痛作用外，还能带来额外益处，因此应考虑是否始终优先于免疫抑制性阿片类药物使用它们。
